HomeMy WebLinkAboutLP aboveground storage tank permit - LP Gas Tank - 68 BEAR HILL ROAD 6/1/2015 (3) (�7/ze Q52po��?/n'l�a�'r�eU-P,c�iG�
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APPLICATION FOR PERMIT
City or Town or�*�X-__A13 8L2-� ` ' y'lr` A- DIG SAFE NUMBER
Date. _
Start Date:
In accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10A application is hereby made
(Full name of person,Firm or Corporation)
Address `�'r, -4% ray't�( W.?94 c`-e 1 44A
(Street or P.O.Box)(City or Town)
For permission to (state clearly purpose for which permit is requested) 1 J- !l /`/O-Z) C
Ak P pc
Name of competent operator(If Applicable) c.L 6 tSa Cert. No.
Date Issued-r*Oed- G /� By
(Signature of Applicant)
Date of expiration ���1/yi�`�iiZ Fee $ Paid dd Due
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FP6(rev.3/00) V. C QZ Jr� e&& Road, V&w, O&C9 0.1 /5
PERMIT
City or Town ��1'0"4'1 �l1 <iG"t'd� DIG SAFE NUMBER
Date "� '� 5
Start Date:
Permit Number(if applicable)
In accordance with the provisions of M.G.L. Chapter 148, as provided in 10A this permit is granted
to 1��r r14i 7`-9G'Yt�f (' w tz3ce>✓ /r � c
—� (Full name of person,Firm of Corporation)
for� jo 7`4l t`tn 1. C� ��� .QT���� C i06--
Restrictions: z z;— d,,%� �/�Tf� �f�r�r✓/aJVE y
at It—) Oi 1�Yam.
(Give location by street and no.,or describe in such manner as to provide adequate identification of location)
Fee Paid$_� This Permit will expire on ��Yf.✓t�
Signature of Official Granting Permit Titlef Lam✓/��
This permit must be,conspicuously posted upon the premises